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LYST 基因复合杂合突变致 Chediak-Higashi 综合征 1 例报告

Identification of a compound heterozygote in LYST gene: a case report on Chediak-Higashi syndrome.

机构信息

Central Laboratory, Zhengzhou People's Hospital Affiliated to Southern Medical University, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.

Binzhou medical University, Yantai, China.

出版信息

BMC Med Genet. 2020 Jan 6;21(1):4. doi: 10.1186/s12881-019-0922-8.

Abstract

BACKGROUND

Chediak-Higashi Syndrome (CHS) is a rare autosomal recessive disease caused by loss of function of the lysosomal trafficking regulator protein. The causative gene LYST/CHS1 was cloned and identified in 1996, which showed significant homology to other species such as bovine and mouse. To date, 74 pathogenic or likely pathogenic mutations had been reported.

CASE PRESENTATION

Here we describe a compound heterozygote in LYST gene, which was identified in a 4-year-old female patient. The patient showed skin hypopigmentation, sensitivity to light, mild splenomegaly and reduction of platelets in clinical examination. Giant intracytoplasmic inclusions were observed in the bone marrow examination, suggesting the diagnosis of CHS. Amplicon sequencing was performed to detect pathogenic mutation in LYST gene. The result was confirmed by two-generation pedigree analysis base on sanger sequencing.

CONCLUSION

A compound heterozygote in LYST gene, consisting of a missense mutation c.5719A > G and an intron mutation c.4863-4G > A, was identified from the patient by using amplicon sequencing. The missense mutation is reported for the first time. Two-generation pedigree analysis showed these two mutations were inherited from the patient's parents, respectively. Our result demonstrated that amplicon sequencing has great potential for accelerating and improving the diagnosis of rare genetic diseases.

摘要

背景

Chediak-Higashi 综合征(CHS)是一种罕见的常染色体隐性疾病,由溶酶体转运调节剂蛋白功能丧失引起。致病基因 LYST/CHS1 于 1996 年被克隆并鉴定,与牛和鼠等其他物种具有显著同源性。迄今为止,已经报道了 74 种致病性或可能致病性突变。

病例介绍

在这里,我们描述了 LYST 基因中的复合杂合子,该基因是在一名 4 岁女性患者中发现的。该患者在临床检查中表现为皮肤色素减退、对光敏感、轻度脾肿大和血小板减少。骨髓检查中观察到巨大的细胞内包涵体,提示 CHS 诊断。对 LYST 基因进行了扩增子测序以检测致病性突变。结果通过基于桑格测序的二代家系分析得到证实。

结论

通过扩增子测序,从患者中鉴定出 LYST 基因的复合杂合子,由错义突变 c.5719A>G 和内含子突变 c.4863-4G>A 组成。该错义突变是首次报道。二代家系分析表明,这两个突变分别来自患者的父母。我们的结果表明,扩增子测序在加速和改善罕见遗传性疾病的诊断方面具有巨大潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8119/6943916/9cdf8bed5966/12881_2019_922_Fig1_HTML.jpg

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